MEDICARE: DR. TIHANA SKARICIC PHARM. D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	RPH 48872	CA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	RPH 48872	OTHER	CA	STATE LICENSE

General Provider Information

NPI Number	:	1306976741
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TIHANA SKARICIC PHARM. D.

Provider Business Mailing Address
First Line	:	16260 VENTURA BLVD STE 100
Second Line	:
City	:	ENCINO
State	:	CA
Zip	:	91436-2207
Country	:	US
Telephone Number	:	818-386-1888
Fax Number	:	818-386-1188

Provider Business Practice Location Address
First Line	:	16260 VENTURA BLVD STE 100
Second Line	:
City	:	ENCINO
State	:	CA
Zip	:	91436-2207
Country	:	US
Telephone Number	:	818-386-1888
Fax Number	:	818-386-1188

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	03/06/2007
Last Update Date	:	07/08/2007

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